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No fixed address? Which state?
Residency rulesDomicile statesNationwide PPO
No fixed address

The truck is home. So which state is yours?

Plenty of drivers live in the sleeper and keep a mail-forwarding address. Health insurance is still sold state by state, so you need a home state on paper. Here is how residency works, and why it makes network reach even more important.

Marketplace residency explained, including the federal rule for people without a fixed address
How a domicile state affects plan choice, and the tax-home rule for per diem
Plans built on nationwide PPO networks, so your home state is not where your care stops
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By Erik Moran, licensed health insurance broker (NPN 20970092) · Updated October 14, 2026
The residency rule

You can be a resident without a street address

Quick answer

For the Marketplace, an adult is a resident of the state where they live and intend to stay, and the federal rule says that includes people without a fixed address. For a driver, your home state is usually the one on your CDL, your vehicle registration and your tax return. You buy that state's plans, so a network that only works in that state does you little good the rest of the month.

Keep your paperwork consistent. A CDL in one state, a tax return in another and a mailing address in a third invites a residency question when you apply, and the Marketplace can ask you to document where you live.

Domicile states

Mail-forwarding domiciles and what they mean for coverage

Full-time travelers, including many drivers, often choose South Dakota, Texas or Florida as a legal domicile, because those states have no state income tax and established mail-forwarding services. That choice has a health insurance side most people do not think about:

  • Your Marketplace plans are that state's plans, built around that state's hospitals.
  • Medicaid rules differ sharply. South Dakota expanded Medicaid; Texas and Florida did not.
  • Private plans are issued in your home state too, and carriers have their own rules about mail-forwarding addresses, so we confirm them before you apply.

We are licensed in all three, and in 30+ states overall. Our domicile state guide goes deeper for full-time travelers.

Tax home

The per diem trap for drivers with no home base

The IRS lets drivers deduct travel expenses, including per diem, only when they are traveling away from their tax home. If you have no regular place of business and no place where you regularly live, the IRS treats you as an itinerant worker whose tax home is wherever you work, and an itinerant cannot claim travel expenses at all.

That matters for health insurance because per diem lowers your net income, which can move you across the 2027 subsidy line. If you live in the truck full time, talk to your tax preparer about your tax home before you count on per diem in a Marketplace estimate. Our calculator shows how much the number moves your result.

Network

Pick the network before you pick the premium

A driver with no fixed address may not see a home-state doctor for months. Telehealth helps for small things, but stitches, X-rays and follow-up visits happen in person, wherever you are. That is the case for a plan built on a nationwide PPO network if you can qualify for one.

The plain truth about private plans: the nationwide PPO plans we quote are private, medically underwritten plans, not Marketplace plans. A nationwide network means in-network doctors and hospitals in many states; it does not mean every service is covered. You answer health questions, and the carrier can decline you or exclude a condition. These plans are not ACA-compliant: depending on the plan, prescriptions, maternity, mental health and other benefits can be limited or left out, some benefits have dollar maximums, and out-of-network care costs more. We walk through exactly what a plan pays before you apply, and if a Marketplace plan fits you better, we tell you that too.

Over or under the 2027 subsidy line?

Self-employed and 1099 income is counted after expenses. Our free calculator shows which side of the 400% line you land on in about a minute, with results right away and no sign-up.

Run the subsidy cliff calculator →
Questions

Questions we hear most

Can I get health insurance if I live in my truck?

Yes. Federal Marketplace rules allow residency without a fixed address if you live in the state and intend to stay. In practice your home state is usually the one on your CDL, registration and tax return.

Can I use a mail-forwarding address for health insurance?

Often, but rules vary. The Marketplace may ask you to document residency, and private carriers have their own address rules. We confirm them before you apply.

Which state should a trucker with no home pick?

That is a legal and tax decision, not just an insurance one. Insurance-wise, compare that state's Marketplace, its Medicaid rules and whether you can get a plan whose network reaches the states you run.

Sources

Checked October 14, 2026. Rules and dates change; confirm before you act.

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